Orthopedic brace having a system of alternately inflatable or deflatable pneumatic pads for adjustable fitting of the brace to the body

ABSTRACT

A hinged knee brace has a system of inflatable pads mounted thereon to adjustably provide secure and comfortable support for the brace against the leg. Each pad is a pneumatic bladder having a valve enabling selective inflation or deflation of the bladder with a fluid to systematically adjust the fit of the brace to the leg in accordance with the needs of the user.

This application is a continuation-in-part patent application of apatent application entitled, "Orthopedic Brace Having Pneumatic Pads",Ser. No. 07/907,160 filed on Jul. 1, 1992, now U.S. Pat. No. 5,316,547.

TECHNICAL FIELD

The present invention relates generally to an orthopedic brace, andparticularly to an orthopedic brace having a pad mounted thereon forsupporting the brace against the body of a user. More particularly,though not exclusively, the present invention relates to an orthopedicbrace having a system of pneumatic pads mounted thereon that support thebrace against the body in close fit therewith by selectively inflatingor deflating the pads in correspondence to the body.

BACKGROUND OF THE INVENTION

Orthopedic braces are commonly employed on the body of a user tostabilize a skeletal joint that has been weakened by injury or otherinfirmity. The braces characteristically have either rigid or elasticstructural components supporting the joint. Typically, the structuralcomponents of rigid braces are dynamically linked together by hingesenabling controlled movement of the joint during rehabilitative therapyor routine user activity. Such braces are positioned on the body so thatthe hinges traverse the joint being stabilized, while the rigidcomponents are secured to the body along a plurality of engagement facesabove and below, as well as adjacent to the joint. Substantially solidelastomeric pads or fluid-filled pneumatic pads are often positioned onthe brace between the body and the rigid support components to enhancethe fit of the brace with the body and to cushion the body of the userfrom the engagement faces.

Despite the placement of pads on rigid braces, the user frequentlyexperiences discomfort from painful point loads while wearing aclosely-fitted padded brace because of the high forces the brace appliesto the body across the engagement faces during routine activity orrehabilitative therapy. Such discomfort is particularly acute where thepad does not possess proper compression characteristics or the brace isnot properly sized and configured in conformance with the structure ofthe brace and the contours of the body. It has also been found that bodytissue undergoes transient changes, such as swelling or shrinkage,during routine or rehabilitative physical activity for which padsemployed in rigid braces are not configured and consequently to whichsuch pads do not readily adjust.

U.S. Pat. No. 4,201,203 discloses an elastic knee brace having anopen-loop, elastomeric pad conformable to the patella. U.S. Pat. No.4,777,946 similarly discloses an elastic knee brace having aclosed-loop, elastomeric pad conformable to the patella. U.S. Pat. No.4,378,009 and U.S. Pat. No. 4,938,207 both disclose elastic knee braceshaving inflatable pneumatic pads conformable to the patella.Nevertheless, corresponding body-conforming pneumatic pads are not foundin rigid orthopedic braces.

U.S. Pat. No. 5,125,400 discloses a rigid orthopedic brace havinginflatable pneumatic pads positioned between the ankle of the user andthe rigid support components of the brace. U.S. Pat. No. 5,107,823discloses a thigh guard having an inflatable pneumatic pad positionedbetween the thigh and a rigid protective shell. In both instances,however, the pads are not significantly configured in conformance withthe corresponding body contours.

Some rigid orthopedic braces have specifically addressed the problem ofclosely fitting the rigid brace with the knee or elbow whilesimultaneously cushioning the body from the brace. French patentpublication FR 2627-381-A discloses a rigid brace having a pair ofrounded, incompressible fluid-trilled pads positioned on the brace toabut the knee or elbow condyles. U.S. Pat. No. 3,581,741 discloses arigid brace having a doughnut-shaped solid elastomeric pad positionedagainst the medial meniscus of the knee in association with an adjacentinflatable pneumatic thigh pad. Yet, the prior art does not disclosepneumatic pads configured in substantial conformance with the contoursof the user's body.

Accordingly, it is an object of the present invention to provide anorthopedic brace that can be secured to the body of a user with both ahigh degree of stable support and a high degree of user comfort. It isfurther an object of the present invention to provide an orthopedicbrace employing a plurality of pads that systematically stabilizes thebrace against the body of the user by dynamically conforming to thecontours of the body and the structure of the brace, while cushioningthe contours from the rigid structural components of the brace.

It is another object of the present invention to provide anoff-the-shelf orthopedic brace that can be adapted to fit the bodycontours of any number of users. It is another object of the presentinvention to provide a custom orthopedic brace that is readilyconfigured to the body contours of a specific individual user. It isstill another object of the present invention to provide an orthopedicbrace having a fit that can be instantaneously adapted to therequirements of different activities by the user. It is a further objectof the present invention to provide an orthopedic brace having a fitthat can be instantaneously adjusted to transient conditions of the bodysuch as localized tissue swelling or shrinkage.

SUMMARY OF THE INVENTION

The present invention is an orthopedic brace having a system ofinflatable pads mounted thereon that adjustably provides a secure andcomfortable fit of the brace against the body of a user. Each padcomprises a pneumatic bladder penetrated by a valve enabling selectivefluid communication between the interior and exterior of the bladder.Thus, the bladders are selectively inflated or deflated with a fluid tosystematically adjust the size, and correspondingly the fit, of thebrace to the body in accordance with the needs of the user.

The present invention is specifically applicable to a hinged knee bracemountable on the leg of a user to stabilize the knee joint byrestricting motion thereof. The brace comprises a frame made up ofsubstantially rigid components including upper and lower leg cuffs and ahinge. The upper leg cuff is engagable with the upper leg above the kneejoint and the lower leg cuff is engagable with the lower leg below theknee joint. The cuffs are rotatably connected across the hinge which ispositionable at the knee joint to pivot in correspondence with flexionand extension of the knee joint as permitted by the brace. The hingecomprises a medial pivot member and a lateral pivot member disposed onopposite sides of the knee joint.

Each cuff comprises a medial arm and a lateral arm longitudinallydisposed on opposite sides of the leg in substantially parallelalignment. The lateral arms of the upper and lower leg cuffs areattached at their one end to the lateral pivot member of the hinge. Themedial arms of the upper and lower leg cuffs are similarly attached atone end to the medial pivot member of the hinge. Each cuff furthercomprises a cross member circumferentially disposed in an arcuateconfiguration on the upper or lower leg. The upper cross member isjoined to the remaining ends of the upper medial and lateral arms andthe lower cross member is similarly joined to the remaining ends of thelower medial and lateral arms with the cross members being substantiallyperpendicularly aligned relative to the arms.

The inner surface of the hinge and upper and lower leg cuffs defineengagement faces of the frame components with the body. Accordingly, thesystem of inflatable pads is positioned on the engagement faces of thebrace between the rigid components and the body of the user for optimalperformance. The system of pads includes medial and lateral upper armpads, medial and lateral lower arm pads, and medial and lateral hingepads removably attached to the engagement faces of the correspondinglypositioned rigid frame components. The areal dimensions and shape of thepads correspond to the areal dimensions and shape of the engagementfaces, enabling the pads to fully cushion the body from the rigid framecomponents.

With the brace in place on the leg of a user, the size, and inparticular the thickness, of the pads is systematically adjusted byinflating or deflating the pads as desired to closely the fit the bracewith the specific contours of the leg of the user. The pad system alsopermits the user to instantaneously adapt the fit of the brace todifferent user activities or to changing conditions of the leg. Thus,for example, if swelling is experienced in the leg, the user can deflatepredetermined pads to reduce the thickness of one or more pads andcorrespondingly reduce the pressure of the brace on the leg, enhancingthe comfort of the user. In contrast, if undesirable movement of thebrace is experienced relative to the leg during vigorous physicalactivity, the user can inflate one or more predetermined pads toincrease the thickness thereof, increasing the pressure of the brace onthe leg and providing a tighter fit of the brace to the leg.

The present invention will be further understood, both as to itsstructure and operation, from the accompanying drawings, taken inconjunction with the accompanying description, in which similarreference characters refer to similar parts.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a knee brace of the present invention.

FIG. 2 is a frontal view of the knee brace of FIG. 1 in place on the legof a user.

FIG. 3 is a frontal view of an arm pad associated with the knee brace ofFIG. 1.

FIG. 4 is a cross-sectional view of the arm pad of FIG. 3 as seen alongline 4--4.

FIG. 5 is a frontal view of a hinge pad associated with the knee braceof FIG. 1.

FIG. 6 is a cross-sectional view of the arm pad of FIG. 5 as seen alongline 6--6.

DESCRIPTION OF PREFERRED EMBODIMENTS

Referring initially to FIG. 1, an orthopedic brace of the presentinvention is shown and generally designated 10. The orthopedic brace 10shown by way of example is a knee brace for the right leg. The brace 10has a frame fabricated from substantially rigid components combined in aconventional design as typified by U.S. Pat. No. 4,697,583, incorporatedherein by reference.

The rigid components of the frame include an upper leg cuff 12, a lowerleg cuff 14, and a hinge 16. The upper leg cuff 12 comprises an uppermedial arm 18 and an upper lateral arm 20 longitudinally disposed onopposite sides of the brace 10 above the hinge 16 in substantiallyparallel alignment with one another. An upper cross member 22 isdisposed substantially perpendicular to the upper medial and lateralarms 18, 20 joining the proximal end 24 of the upper medial arm 18opposite the hinge 16 with the corresponding proximal end 26 of theupper lateral arm 20. The upper cross member 22 has an arcuateconfiguration forming an anterior arc substantially in the shape of apartial circle or ellipse that conforms to the circumferential contourof the upper leg as will be shown with reference to FIG. 2.

The lower leg cuff 14 similarly comprises a lower medial arm 30 and alower lateral arm 32 longitudinally disposed on opposite sides of thebrace 10 below the hinge 16 in substantially parallel alignment with oneanother. A lower cross member 34 is disposed substantially perpendicularto the lower medial and lateral arms 30, 32 joining the distal end 36 ofthe lower medial arm 30 opposite the hinge 16 with the correspondingdistal end 38 of the lower lateral arm 32. The lower cross member 34 hasan arcuate configuration forming a posterior arc substantially in theshape of a partial circle or ellipse that conforms to thecircumferential contour of the lower leg as will also be shown withreference to FIG. 2.

The hinge 16 comprises a medial pivot member 40 and a lateral pivotmember 42 disposed on opposite sides of the brace 10 and intermediatelypositioned between the upper and lower leg cuffs 12, 14. The distal end44 of the upper medial arm 18 is rotatably attached to the proximal end46 of the lower medial arm 30 at the medial pivot member 40. The distalend 48 of the upper lateral arm 20 is correspondingly rotatably attachedto the proximal end 50 of the lower lateral arm 32 at the lateral pivotmember 42.

In addition to the above-described rigid frame components, the brace 10further comprises a pair of upper straps 52 above the hinge 16 and apair of lower straps 54 below the hinge 16 to secure the brace 10 to theleg of a user. The upper straps 52 circumscribe the posterior of thebrace 10 opposite the upper cross member 22 and the lower straps 54similarly circumscribe the anterior of the brace 10 opposite the lowercross member 34. The straps 52, 54 are attached to the frame of thebrace 10 by means of loop fixtures 56.

Each of the rigid frame components has an inner surface engageable withthe leg that is accordingly termed an engagement face. Thus, the uppermedial arm 18 has an engagement face 58, the upper lateral arm 20 has anengagement face 60, and the upper cross member 22 has an engagement face62. Similarly, the lower medial arm 30 has an engagement face 64, thelower lateral arm 32 has an engagement face 66, and the lower crossmember 34 has an engagement face 68. Finally, the medial and lateralpivot members 40 and 42 have engagement faces 70 and 72, respectively.

The brace 10 further comprises a system of pads removably attachable tothe above-recited engagement faces, thereby positionable between therigid frame components and the leg of the user as will be shown withreference to FIG. 2. The pad system comprises a plurality of arm padsincluding an upper medial arm pad 74, an upper lateral arm pad 76, alower medial arm pad 78 and a lower lateral arm pad 80. Arm pads 74, 76,78, 80 all have a substantially identical configuration and constructionas will be described hereafter with reference to FIGS. 3 and 4.

The pad system further comprises a pair of hinge pads including a medialhinge pad 82 and a lateral hinge pad 84, both having a substantiallyidentical configuration and construction as will be described hereafterwith reference to FIGS. 5 and 6. From FIG. 1, however, it is apparentthat the arm pads 74, 76, 78, 80 substantially correspond to the profileof the respective arm engagement faces 58, 60, 64, 66 and a portion ofthe adjoining cross member engagement faces 62, 68. The hinge pads 82,84 likewise substantially correspond to the profile of the respectivepivot member engagement faces 70, 72.

All of the pads are removably attachable to the respective engagementfaces by conventional means, such as hook and loop fasteners commonlyknown as VELCRO (not shown in FIG. 1). The preferred fastener is asegment of the hook or loop material fixably attached to the side of apad abutting the respective engagement face and a complementary segmentof the hook or loop material fixably attached to the engagement face. Agarment material, such as natural or synthetic cloth or leather, mayfurther be affixed to the opposite side of the pad abutting the body toenhance the comfort of the user. Synthetic chamois is a preferredgarment material.

Each of the arm pads 74, 76, 78, 80 and hinge pads 82, 84 is preferablyalternately inflatable or deflatable by means of a selectively sealablevalve as shown in FIG. 1 by representative substantially identicalvalves 86 and 88 that are integrally formed in the upper lateral arm pad76 and the lateral hinge pad 84, respectively. The valve 86 permitsselective fluid communication between the interior and exterior of thepad 76 with the valve 86 preferably biased in the closed position andopened by insertion of a pump needle (not shown) therein. A detachablepump or a pump integral with each valve (not shown) can be used toinflate the respective pad. Teaching of such pumps and valves isconventional and, thus, well known to those skilled in the art.

In any case, a preferred fluid for injection by means of a pump into apad in the manner set forth above is a compressible fluid, morepreferably a gas, and most preferably air at ambient atmosphericconditions. The injection of other gaseous, liquid or gel-like fluids,however, is possible within the scope of the present invention. It isfurther understood that the injected fluid can conversely be withdrawnfrom a pad by opening a valve and displacing the fluid in the padinterior through the valve to the exterior thereof.

The relative positioning of the brace 10 including the pad system isshown on the right leg 90 of a user with reference to FIG. 2. Forclarity the straps 52, 54 are not shown, but it is understood that inpractice the straps 52, 54 would be present and functional. FIG. 2 showsthe upper leg cuff 12 engaging the upper leg 92, and specificallyengaging the medial, lateral and anterior thigh region. It is furtherapparent from FIG. 2 that the lower leg cuff 14 engages the lower leg94, and specifically engages the medial, lateral and posterior calfregion. The arm pads 74, 76, 78, 80, which are positioned between theupper and lower leg cuffs 12, 14 and the upper and lower legs 92, 94,respectively, are shown to fit snugly therebetween, compressed flushagainst the relatively smooth even surfaces of the upper and lower legs92, 94 and the respective engagement faces. In so doing, the arm pads74, 76, 78, 80 provide a close even overall fit of the brace 10 with theleg 90.

The hinge 16 is positioned adjacent to the knee joint 96 to transferloads between the upper and lower leg cuffs 12, 14 and to restrictflexion or extension of the knee joint 96 as desired in accordance withconventional flexion or extension restriction means, such as taught byU.S. Pat. Nos. 4,481,941 and 4,531,515. The medial and lateral pivotmembers 40, 42 engage the medial and lateral condyles 98,100,respectively, of the knee joint 96. The hinge pads 82, 84 are positionedbetween the medial and lateral pivot members 40, 42 and the medial andlateral condyles 98,100, respectively, to compress flush against thesmooth even surfaces of the pivot member engagement faces 70 72, whileconforming around the protruding condyles 98,100. Thus, the hinge pads82, 84 augment the arm pads 74, 76, 78, 80 in fitting the brace 10 tothe leg 90.

Details of the preferred configuration and construction of the arm pads74, 76, 78, 80 are described with reference to FIGS. 3 and 4, whereinthe upper lateral arm pad 76 is shown as representative of all the armpads. The pad 76 is a fluid-retaining bladder 102 having a peripheralseam 104 that is penetrated by the valve 86 integrally positioned in theseam 104. The pad 76 also has an interior seam 106 surrounded by thebladder 102 and peripheral seam 104.

When independent of the associated upper lateral arm 20 and upper crossmember 22, the free-standing pad 76 is substantially planar. However,when attached to the arm 20 and adjoining upper cross member 22 as shownin FIG. 2, the inflated pad 76 is twistable to a three-dimensionalconfiguration conforming thereto, and substantially covering theengagement face 60 and a portion of the engagement face 62 correspondingto one quadrant of a circle defined by the cross member 22. Remainingpads 74, 78, 80 similarly conform to respective engagement faces asshown in FIG. 2.

The presence of the interior seam 106 on the pad 76 facilitatesconformance of the pad 76 to the respective engagement faces 60, 62,thereby enhancing the fit of the brace 10 to the leg 90. The interiorseam 106 also functions to desirably increase the contact interfacebetween the pad 76 and the upper leg cuff 12, further enhancing the fitof the brace 10 to the leg 90. The interior seam 106 essentiallybifurcates the substantially convex, tubular-shaped bladder 102, therebysignificantly increasing the contact surface of the pad 76 relative to asimilar configuration absent the interior seam 106.

Referring to FIG. 4, the pad 76 is shown to have a laminate constructioncomprising two continuous sheets 108, 110 of a fluid-impervious filmmaterial covered by a single sheet of the garment material 112 on theleg-facing side 114 of the pad 76, and a single sheet of a fastenablematerial 116 on the opposite brace-facing side 118 of the pad 76. Thefilm material is a highly-flexible, elastically-collapsible materialthat is preferably gas-impervious, such as a plastic, e.g., polyurethaneor polyvinyl chloride. The fastenable material is preferably a loopcoupling of a hook and loop fastener or, alternatively, the hookcoupling thereof.

The pad 76 is constructed by overlaying the first sheet 108 atop thesecond sheet 110 and placing the sheet of garment material 112 and thesheet of fastenable material 116 on either side of the sheets 108,110.An adhesive may be placed between sheets 108 and 112 or between sheets110 and 116 to bond the respective sheets together. The components ofthe valve 86 are subsequently placed at a desired location between thesheets 108, 110 where the peripheral seam 104 is to be formed.

The peripheral seam 104 is formed by joining all of the sheets108,110,112, 114 together along the continuous path of the outerperimeter of the pad 76 using conventional means, such as high radiofrequency (r.f.) welding or thermal welding. The valve 86 is likewisebonded into the seam 104. The interior seam 106 is similarly formed byjoining the sheets 108, 110, 112, 114 together along the predeterminedinterior path.

If desired, the tubular, or alternately hemi-tubular, configuration ofthe pad 76 can be preformed by preliminarily thermoforming both or oneof the sheets 108, 110 in a hemi-tubular shape prior to joining themtogether. Inflation of the pad 76, however, is generally sufficient toestablish the tubular configuration thereof without the preforming step.

Details of the preferred configuration and construction of the hingepads 82, 84 are described with reference to FIGS. 5 and 6, wherein thelateral hinge pad 84 is shown as representative of both hinge pads. Likethe arm pad 76, the hinge pad 84 is a fluid-retaining convex bladder102' enclosed by a peripheral seam 104' that is penetrated by the valve88 integrally positioned in the seam 104'. An interior seam 106' islikewise provided that is surrounded by the bladder 102' and theperipheral seam 104'.

The pad 84 has a substantially planar configuration whetherfree-standing independent of the associated pivot member 42 or attachedthereto. The pad 84 effectively covers the engagement face 72 whenattached thereto. The remaining pad 82 similarly conforms to theengagement face 70 as shown in FIG. 2.

The presence of the interior seam 106' on the pad 84 facilitatesconformance of the pad 84 to the protruding condyle 100, therebyenhancing the fit of the brace 10 to the leg 90. The interior seam 106'provides the bladder 102' with a substantially convex toroidal shapethat is bounded on the outer perimeter by the seam 104' and bounded onthe inner perimeter by the seam 106'.

Referring to FIG. 6, the pad 84, like pad 76, is shown to have alaminate construction comprising sheets 108', 110', 112',116' similar tosheets 108,110,112,116, respectively. It is apparent that the sheets ofthe pad 84 are combined in substantially the same manner as pad 76.However, a second bladder 120 arealy interior to bladder 102' mayadditionally be provided in the pad 84 by maintaining thefluid-impervious integrity of the sheets 108', 110' interior to the seam106'.

The interior bladder 120 can be in fluid isolation from the bladder 102'and can be evacuated or have a fluid, such as air, sealed therein duringthe fabrication process. In yet another alternative not shown, thebladder 120 can be in fluid communication with the bladder 102' by meansof gaps provided in the seam 106', thereby rendering the bladder 120simultaneously inflatable with the bladder 102'.

In any case, where a second bladder 120 is provided interior to thebladder 102', the bladders 102' and 120 are constructed such that thebladder 102' always maintains a greater elevation than the bladder 120when the bladder 102' is inflated. Thus, the distance separating sheets108', 110' within the bladder 102' is substantially greater than thedistance of separation within the second bladder 120. Thischaracteristic enables the pad 84 to receive the protrusion of thecondyle 100 within the interior of the bladder 102', therebysubstantially securing the brace 10 about the knee joint 96 whileenhancing the comfort of the user.

Although preferred embodiments of the arm pad 76 and the hinge pad 84have been shown and described above, it is apparent that otherembodiments of the pads, although not shown, are possible within thescope of the present invention. For example, the present inventionprovides for an alternate embodiment of a hinge pad having only a singleprimary bladder similar in configuration to the bladder 102' of FIG. 5.Unlike the pad 84 of FIG. 5, however, the second bladder is excludedfrom the central opening of the toroidal-shaped bladder so that theopening is maintained as a void.

Further within the scope of the present invention, it is understood thatthe bladder of the hinge pad need not have a continuous toroidal shape,but may have substantially any shape defining a closed-loop or open-looppathway that conforms to the perimeter of a condyle and that provides aninterior opening for receiving the condyle. It is desirable that thebladder is sufficiently inflated to maintain the thickness of thebladder greater than the height of the protruding condyle receivedtherein during use of the brace to prevent substantial compressivecontact of the condyle with the rigid hinge.

Alternative means for producing the pads of the present invention arealso provided within the scope of the invention. For example, the padscan be formed from a single sheet of film material, rather than twosheets as disclosed above, by joining the edges of a single sheettogether and welding the resulting joint, thus, forming a bladder sealedat the weld or welds. In other production alternatives, the pad may beformed by blow molding or other conventional molding methods availableto one skilled in the art.

Also encompassed within the present invention is a method for initiallyfitting the brace 10 to the body of a user, or subsequently modifyingthe fit of the brace 10 in response to different activities performed bythe user, or in response to variations in the condition of the body partadjacent to the brace 10. The method comprises individually controllingthe size, and in particular the thickness, of each pad by systematicallyinjecting or withdrawing fluid through the valve, i.e., inflating ordeflating the pad, in accordance with the specific needs of the user.Thus, for example, if the initial fit of the brace 10 is too loose aboutthe upper leg 92, upper arm pads 74, 76 can be inflated, increasingtheir thickness until a snug fit is achieved. If maximum inflation ofthe pad is reached without achieving a proper fit, the pad can beremoved and replaced with a pad having a larger capacity. By providing amatrix of pads with different inflation capacities, a virtually customfit of the brace can be assured.

If the brace 10 is initially fitted correctly on the leg, but the legsubsequently swells due to activity or treatment, the pressure of theleg against the brace can be relieved by systematically withdrawingfluid from the pads, reducing their thickness until an acceptable degreeof comfort is achieved. Conversely, if swelling of the leg subsequentlydiminishes due to healing, the pressure of the leg against the brace canbe increased by systematically injecting fluid into the pads, increasingtheir thickness. In yet another application of the present method, thedegree of inflation, and correspondingly the thickness, of the pads canbe systematically increased to desirably tighten the fit of the braceand prevent slippage in anticipation of vigorous activity. Conversely,the degree of inflation, and correspondingly the thickness, of the padscan be systematically decreased to desirably loosen the fit of the bracein anticipation of relaxation.

While the forgoing preferred embodiments of the invention have beendescribed and shown, it is understood that alternatives andmodifications, such as those suggested and others, may be made theretoand fall within the scope of the invention.

We claim:
 1. A knee brace positionable on a leg and having at least oneinflatable or deflatable pad for selectively fitting the brace to theleg, said brace comprising:an upper leg cuff having an elongated upperarm with a proximal end, a distal end and an upper longitudinal insideface, and said upper leg cuff further having an arcuate upper crossmember with an upper circumferential inside face, wherein said uppercross member is attached to said proximal end of said upper arm and isaligned substantially perpendicular to said upper arm, and furtherwherein said upper longitudinal inside face is positionable adjacent tothe upper leg substantially parallel to the longitudinal axis thereofand said upper circumferential inside face is positionable adjacent tothe upper leg substantially perpendicular to the longitudinal axisthereof; a lower leg cuff having an elongated lower arm with a proximalend, a distal end and a lower longitudinal inside face, and said lowerleg cuff further having an arcuate lower cross member with a lowercircumferential inside face, wherein said lower cross member is attachedto said distal end of said lower arm and is aligned substantiallyperpendicular to said lower arm, and further wherein said lowerlongitudinal inside face is positionable adjacent to the lower legsubstantially parallel to the longitudinal axis thereof and said lowercircumferential inside face is positionable adjacent to the lower legsubstantially perpendicular to the longitudinal axis thereof; a hingerotatably attached to said distal end of said upper arm and saidproximal end of said lower arm, wherein said hinge has an intermediateinside face positionable adjacent to the knee joint; and at least onepad positioned on said upper or lower longitudinal inside face, whereinat least a portion of said pad has a profile substantially correspondingto a profile of said respective upper or lower longitudinal inside face,and wherein said pad is in fluid isolation from the exterior environmentand said pad comprises a fluid-retaining bladder and a selectivelysealable valve penetrating said bladder enabling injection of fluid intoor withdrawal of fluid from said bladder.
 2. A knee brace as recited inclaim 1 wherein said at least one pad has a substantially right angleconfiguration and said profile of said pad substantially corresponds tosaid profile of said respective upper or lower longitudinal inside faceand at least a portion of a profile of said respective upper or lowercircumferential inside face.
 3. A knee brace as recited in claim 1wherein said upper arm is an upper medial arm and said brace furthercomprises an upper lateral arm wherein said upper longitudinal insidefaces of said upper medial and lateral arms are aligned in opposition toone another and said brace further comprises a system of pads includinga first of said at least one pads positioned on said upper longitudinalmedial inside face and a second of said at least one pads positioned onsaid upper longitudinal lateral inside face.
 4. A knee brace as recitedin claim 1 wherein said lower arm is a lower medial arm and said bracefurther comprises a lower lateral arm wherein said lower longitudinalinside faces of said lower medial and lateral arms are aligned inopposition to one another and said brace further comprises a system ofpads including a first of said at least one pads positioned on saidlower longitudinal medial inside face and a second of said at least onepads positioned on said lower longitudinal lateral inside face.
 5. Aknee brace as recited in claim 1 wherein said intermediate inside faceis an intermediate medial or lateral inside face and said brace furthercomprises a system of pads including a first of said at least one padspositioned on said upper or lower longitudinal inside face and a secondof said at least one pads positioned on said intermediate medial orlateral inside face.
 6. A knee brace positionable on a leg and having asystem of inflatable or deflatable pads for selectively fitting thebrace to the leg, said brace comprising:an upper leg cuff having aplurality of upper inside faces including an upper longitudinal medialface and an upper longitudinal lateral face opposing said upperlongitudinal medial face, wherein said upper inside faces arepositionable adjacent to the upper leg; a lower leg cuff having aplurality of lower inside faces including a lower longitudinal medialface and a lower longitudinal lateral face opposing said mediallongitudinal lower face, wherein said lower inside faces arepositionable adjacent to the lower leg; a hinge rotatably connectingsaid upper leg cuff and said lower leg cuff, wherein said hinge has anintermediate inside face positionable adjacent to the knee joint; and asystem of pads positioned on said inside faces, including an uppermedial pad positioned on said upper medial face, an upper lateral padpositioned on said upper lateral face, a lower medial pad positioned onsaid lower medial face, and a lower lateral pad positioned on said lowerlateral face, wherein said pads of said system are in fluid isolationfrom one another and each said pad comprises a fluid-retaining bladderand a selectively sealable valve penetrating said bladder enablinginjection of fluid into or withdrawal of fluid from said bladder.
 7. Aknee brace as recited in claim 6 wherein said upper medial face is on anupper medial arm of said upper leg cuff and the profile of said uppermedial pad substantially corresponds to the profile of said upper medialface.
 8. A knee brace as recited in claim 6 wherein said upper lateralface is on an upper lateral arm of said upper leg cuff and the profileof said upper lateral pad substantially corresponds to the profile ofsaid upper lateral face.
 9. A knee brace as recited in claim 6 whereinsaid upper inside faces include an upper circumferential face on anarcuate upper cross member of said upper leg cuff substantiallyperpendicular to said upper medial and lateral faces, and whereinportions of said upper medial pad and said upper lateral pad engage saidupper circumferential face.
 10. A knee brace as recited in claim 6wherein said lower medial face is on a lower medial arm of said lowerleg cuff and the profile of said lower medial pad substantiallycorresponds to the profile of said lower medial face.
 11. A knee braceas recited in claim 6 wherein said lower lateral face is on a lowerlateral arm of said lower leg cuff and the profile of said lower lateralpad substantially corresponds to the profile of said lower lateral face.12. A knee brace as recited in claim 6 wherein said lower inside facesinclude a lower circumferential face on an arcuate lower cross member ofsaid lower leg cuff substantially perpendicular to said lower medial andlateral faces, and wherein portions of said lower medial pad and saidlower lateral pad engage said lower circumferential face.
 13. A kneebrace as recited in claim 6 wherein said intermediate inside face is anintermediate medial or lateral inside face and said system of padsincludes an intermediate medial or lateral pad positioned on saidrespective intermediate medial or lateral inside face.
 14. A knee bracepositionable on a leg and having at least one inflatable or deflatablepad for selectively fitting the brace to the leg, said bracecomprising:an upper leg cuff having an elongated upper arm with aproximal end, a distal end and an upper longitudinal inside face, andsaid upper leg cuff further having an arcuate upper cross member with anupper circumferential inside face, wherein said upper cross member isattached to said proximal end of said upper arm and is alignedsubstantially perpendicular to said upper arm, and further wherein saidupper longitudinal inside face is positionable adjacent to the upper legsubstantially parallel to the longitudinal axis thereof and said uppercircumferential inside face is positionable adjacent to the upper legsubstantially perpendicular to the longitudinal axis thereof; a lowerleg cuff having an elongated lower arm with a proximal end, a distal endand a lower longitudinal inside face, and said lower leg cuff furtherhaving an arcuate lower cross member with a lower circumferential insideface, wherein said lower cross member is attached to said distal end ofsaid lower arm and is aligned substantially perpendicular to said lowerarm, and further wherein said lower longitudinal inside face ispositionable adjacent to the lower leg substantially parallel to thelongitudinal axis thereof and said lower circumferential inside face ispositionable adjacent to the lower leg substantially perpendicular tothe longitudinal axis thereof; a hinge rotatably attached to said distalend of said upper arm and said proximal end of said lower arm, whereinsaid hinge has an intermediate inside face positionable adjacent to theknee joint; and at least one pad positioned on said intermediate insideface having a profile substantially corresponding to a profile of saidintermediate inside face, and wherein said pad is in fluid isolationfrom the exterior environment and said pad comprises a fluid-retainingbladder and a selectively sealable valve penetrating said bladderenabling injection of fluid into or withdrawal of fluid from saidbladder.
 15. A knee brace as recited in claim 14 wherein saidintermediate inside face is an intermediate medial inside face and saidbrace further comprises a lateral inside face and a system of padsincluding a first of said at least one pads positioned on saidintermediate medial inside face and a second of said at least one padspositioned on said intermediate lateral inside face.
 16. A knee brace asrecited in claim 14 wherein said bladder of said pad has a loop pathwaydefining an interior opening in said pad sized to receive a medial orlateral knee condyle.
 17. A knee brace positionable on a leg and havinga system of inflatable or deflatable pads for selectively fitting thebrace to the leg, said brace comprising:an upper leg cuff having aplurality of upper inside faces including an upper longitudinal medialface and an upper longitudinal lateral face opposing said upperlongitudinal medial face, wherein said upper inside faces arepositionable adjacent to the upper leg; a lower leg cuff having aplurality of lower inside faces including a lower longitudinal medialface and a lower longitudinal lateral face opposing said mediallongitudinal lower face, wherein said lower inside faces arepositionable adjacent to the lower leg; a hinge rotatably connectingsaid upper leg cuff and said lower leg cuff, wherein said hinge has aplurality of intermediate inside faces including an intermediate medialface and an intermediate lateral face, and further wherein said pads arepositioned in opposition to one another and are positionable adjacent tothe knee joint; and a system of pads positioned on said inside faces,including an intermediate medial pad positioned on said intermediatemedial face and having a profile corresponding thereto, and anintermediate lateral pad positioned on said intermediate lateral faceand having a profile corresponding thereto, wherein said pads of saidsystem are in fluid isolation from one another and each said padcomprises a fluid-retaining bladder and a selectively sealable valvepenetrating said bladder enabling injection of fluid into or withdrawalof fluid from said bladder.
 18. A knee brace as recited in claim 17wherein said bladder of said intermediate medial pad or saidintermediate lateral pad has a loop pathway defining an interior openingin said intermediate medial or lateral pad sized to receive a medial orlateral knee condyle, respectively.
 19. A knee brace as recited in claim18 wherein said intermediate medial pad or said intermediate lateral padhas a secondary bladder positioned within said interior opening having athickness substantially less than the thickness of said bladder.
 20. Aknee brace as recited in claim 19 wherein said secondary bladder is influid isolation from said bladder.
 21. A knee brace as recited in claim19 wherein said bladder of said intermediate medial pad or saidintermediate lateral pad comprises a first sheet of an elasticallydeformable film, a second sheet of an elastically deformable filmoverlying said first sheet, a first seam sealingly joining said secondsheet to said first sheet and containing said valve, thereby defining atleast a portion of an outer perimeter of said bladder having a fluidcontainment chamber between said first and second sheets, and a secondseam sealingly joining second sheet to said first sheet, therebydefining at least a portion of an inner perimeter of said bladder.
 22. Aknee brace as recited in claim 21 wherein said loop pathway is a closedloop and said second seam is discontinuous with said first seam.
 23. Aknee brace as recited in claim 21 wherein said loop pathway is an openloop and said second seam is continuous with said first seam.
 24. A kneebrace positionable on a leg comprising:an upper leg cuff having aplurality of upper inside faces including an upper longitudinal insideface and an upper circumferential inside face, wherein said uppercircumferential inside face is aligned substantially perpendicular tosaid upper longitudinal inside face, and further wherein said upperinside faces are positionable adjacent to the upper leg; a lower legcuff having a plurality of lower inside faces including a lowerlongitudinal inside face and a lower circumferential inside face,wherein said lower circumferential inside face is aligned substantiallyperpendicular to said lower longitudinal inside face, and furtherwherein said lower inside faces are positionable adjacent to the lowerleg; a hinge rotatably connecting said upper leg cuff and said lower legcuff, wherein said hinge has an intermediate inside face positionableadjacent to the knee joint; and a pad positioned on said upperlongitudinal and circumferential inside faces or positioned on saidlower longitudinal and circumferential inside faces, wherein said padhas a profile substantially corresponding to at least a portion of aprofile of said respective upper or lower inside faces, and furtherwherein said pad is in fluid isolation from the exterior environment andsaid pad comprises a fluid-retaining bladder and a selectively sealablevalve penetrating said bladder enabling injection of fluid into orwithdrawal of fluid from said bladder.
 25. A knee brace as recited inclaim 24 wherein said pad has a substantially right angle configurationand said profile of said pad substantially corresponds to a profile ofsaid respective upper or lower longitudinal inside face and at least aportion of a profile of said respective upper or lower circumferentialinside face.
 26. A knee brace as recited in claim 24 wherein said upperand lower longitudinal inside faces are substantially flat and saidupper and lower circumferential inside faces are substantially arcuate.27. A knee brace as recited in claim 24 wherein said pad has afluid-containing bladder and an interior seam substantially aligned withthe longitudinal axis of said pad to divide said bladder.